Hand splints for patients suffering from traumatic brain injury (TBI), stroke, cerebral palsy or other forms of neurological impairment are optimally chosen based upon consideration of several factors.
 
As Occupational Therapists, we primarily assess the following areas in our patients before deciding upon a hand splint which achieves optimal form, fit and function.  Initially, we should assess the patient and consider the following questions:
  1. Degree, level or severity of SPASTICITY (muscle tightness)?
  2. Size of the hand and forearm?
  3. Is the client a child or adult?
  4. Skin integrity status?  Determining skin integrity (fragile, thin skin, or healthy, younger robust skin) is important because shearing, heat generation, and friction can occur when wearing a hand splint.
  5. Goals of the patient?  What are we attempting to achieve with the splint?
For the sake of this post, we will discuss hand splints for two classical patient types: Patients with Low Tone and patients with High Tone.

Tone or spasticity are simply descriptive terms used to describe the extent or degree of muscle tightness.  

I am going to recommend splints for the two basic positions that we normally achieve when wearing a hand splint: the resting hand position and a semi-flexed finger positional splint for those patients who present with higher levels of flexor tightness.

For those individuals with high flexor tone in the fingers (they cannot extend their fingers out fully), a full resting hand position is not normally possible because of the finger tightness.
 

Mild to Moderate: Splint recommendations for patients with less tone and a fair to good range of motion:

The resting hand splint options listed below will best serve patients with low tone, minimal muscle tightness and with fingers that can generally be fully extended or nearly fully extended with ease. The goals we want to achieve with this particulars model of splint is a resting hand position, finger separation and 80% to 90% full finger extension.

Comfyprene Separate Finger Hand Orthosis Comfyprene Separate Finger Hand Orthosis
LMB Air-Soft Resting Hand Splint LMB Air-Soft Resting Hand Splint
Opposition Hand Thumb Orthosis Opposition Hand Thumb Orthosis
Resting Hand Orthosis With Finger Separators Resting Hand Orthosis With Finger Separators
Progress Neutral Resting Splints Progress Neutral Resting Splints
Progress Dorsal Anti-Spasticity Splint Progress Dorsal Anti-Spasticity Splint
 

Moderate to Severe: Splint recommendations for patients with higher tone and a fair to poor range of motion:

In the hyperlinks below, I have suggested splints which optimally serve patients with High Tone, significant muscle tightness, and some flexor spasticity and/or contracture that may be developing. The goals we want to achieve with these splints is a semi-resting hand position, prevention of further contracture or flexor tightness, and an encouragement of greater extension of tight finger digits.
 
Palm Cone With Finger Separator Palm Cone With Finger Separator
For severe contractures
Pucci AirT Inflatable Hand Splint Pucci AirT Inflatable Hand Splint
For less severe contractures
Pucci Air Short Inflatable Hand Splint Pucci Air Short Inflatable Hand Splint
For hand contractures with no wrist involvement
Comfy Adjustable Cone Hand Splint Comfy Adjustable Cone Hand Splint
Cone splint
Contour Hand Orthosis With Finger Separators Contour Hand Orthosis With Finger Separators
Moldable plastic for customization
Comfy Splints Spring-Loaded Finger Extender Orthosis Comfy Splints Spring-Loaded Finger Extender Orthosis
Promotes Extension of the Wrist
DeRoyal Pucci EZE Hand Orthosis DeRoyal Pucci EZE Hand Orthosis
My Favorite!


Finally, these are the best categories for shopping for hand splints and hand orthoses on Rehabmart.com!

  1. Wrist and Hand Splints
     
  2. Hand and Finger Splints